Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study

Abstract It was recently reported that hepatocellular carcinoma (HCC) patients with non-alcoholic steatohepatitis (NASH) are not responsive to immune-checkpoint inhibitor (ICI) treatment. The present study aimed to evaluate the therapeutic efficacy of lenvatinib in patients with non-alcoholic fatty...

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Autores principales: Atsushi Hiraoka, Takashi Kumada, Toshifumi Tada, Joji Tani, Kazuya Kariyama, Shinya Fukunishi, Masanori Atsukawa, Masashi Hirooka, Kunihiko Tsuji, Toru Ishikawa, Koichi Takaguchi, Ei Itobayashi, Kazuto Tajiri, Noritomo Shimada, Hiroshi Shibata, Hironori Ochi, Kazuhito Kawata, Satoshi Yasuda, Hidenori Toyoda, Tomoko Aoki, Takaaki Tanaka, Hideko Ohama, Kazuhiro Nouso, Akemi Tsutsui, Takuya Nagano, Norio Itokawa, Taeang Arai, Tomomi Okubo, Michitaka Imai, Yohei Koizumi, Shinichiro Nakamura, Koji Joko, Yoichi Hiasa, Masatoshi Kudo, The Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
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spelling oai:doaj.org-article:1c086d02fb67435ca602adcb170580af2021-12-02T16:45:41ZEfficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study10.1038/s41598-021-96089-x2045-2322https://doaj.org/article/1c086d02fb67435ca602adcb170580af2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-96089-xhttps://doaj.org/toc/2045-2322Abstract It was recently reported that hepatocellular carcinoma (HCC) patients with non-alcoholic steatohepatitis (NASH) are not responsive to immune-checkpoint inhibitor (ICI) treatment. The present study aimed to evaluate the therapeutic efficacy of lenvatinib in patients with non-alcoholic fatty liver disease (NAFLD)/NASH-related unresectable-HCC (u-HCC). Five hundred thirty u-HCC patients with Child–Pugh A were enrolled, and divided into the NAFLD/NASH (n = 103) and Viral/Alcohol (n = 427) groups. Clinical features were compared in a retrospective manner. Progression-free survival (PFS) was better in the NAFLD/NASH than the Viral/Alcohol group (median 9.3 vs. 7.5 months, P = 0.012), while there was no significant difference in overall survival (OS) (20.5 vs. 16.9 months, P = 0.057). In Cox-hazard analysis of prognostic factors for PFS, elevated ALT (≥ 30 U/L) (HR 1.247, P = 0.029), modified ALBI grade 2b (HR 1.236, P = 0.047), elevated AFP (≥ 400 ng/mL) (HR 1.294, P = 0.014), and NAFLD/NASH etiology (HR 0.763, P = 0.036) were significant prognostic factors. NAFLD/NASH etiology was not a significant prognostic factor in Cox-hazard analysis for OS (HR0.758, P = 0.092), whereas AFP (≥ 400 ng/mL) (HR 1.402, P = 0.009), BCLC C stage (HR 1.297, P = 0.035), later line use (HR 0.737, P = 0.014), and modified ALBI grade 2b (HR 1.875, P < 0.001) were significant. Lenvatinib can improve the prognosis of patients affected by u-HCC irrespective of HCC etiology or its line of treatment.Atsushi HiraokaTakashi KumadaToshifumi TadaJoji TaniKazuya KariyamaShinya FukunishiMasanori AtsukawaMasashi HirookaKunihiko TsujiToru IshikawaKoichi TakaguchiEi ItobayashiKazuto TajiriNoritomo ShimadaHiroshi ShibataHironori OchiKazuhito KawataSatoshi YasudaHidenori ToyodaTomoko AokiTakaaki TanakaHideko OhamaKazuhiro NousoAkemi TsutsuiTakuya NaganoNorio ItokawaTaeang AraiTomomi OkuboMichitaka ImaiYohei KoizumiShinichiro NakamuraKoji JokoYoichi HiasaMasatoshi KudoThe Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)Nature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Atsushi Hiraoka
Takashi Kumada
Toshifumi Tada
Joji Tani
Kazuya Kariyama
Shinya Fukunishi
Masanori Atsukawa
Masashi Hirooka
Kunihiko Tsuji
Toru Ishikawa
Koichi Takaguchi
Ei Itobayashi
Kazuto Tajiri
Noritomo Shimada
Hiroshi Shibata
Hironori Ochi
Kazuhito Kawata
Satoshi Yasuda
Hidenori Toyoda
Tomoko Aoki
Takaaki Tanaka
Hideko Ohama
Kazuhiro Nouso
Akemi Tsutsui
Takuya Nagano
Norio Itokawa
Taeang Arai
Tomomi Okubo
Michitaka Imai
Yohei Koizumi
Shinichiro Nakamura
Koji Joko
Yoichi Hiasa
Masatoshi Kudo
The Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study
description Abstract It was recently reported that hepatocellular carcinoma (HCC) patients with non-alcoholic steatohepatitis (NASH) are not responsive to immune-checkpoint inhibitor (ICI) treatment. The present study aimed to evaluate the therapeutic efficacy of lenvatinib in patients with non-alcoholic fatty liver disease (NAFLD)/NASH-related unresectable-HCC (u-HCC). Five hundred thirty u-HCC patients with Child–Pugh A were enrolled, and divided into the NAFLD/NASH (n = 103) and Viral/Alcohol (n = 427) groups. Clinical features were compared in a retrospective manner. Progression-free survival (PFS) was better in the NAFLD/NASH than the Viral/Alcohol group (median 9.3 vs. 7.5 months, P = 0.012), while there was no significant difference in overall survival (OS) (20.5 vs. 16.9 months, P = 0.057). In Cox-hazard analysis of prognostic factors for PFS, elevated ALT (≥ 30 U/L) (HR 1.247, P = 0.029), modified ALBI grade 2b (HR 1.236, P = 0.047), elevated AFP (≥ 400 ng/mL) (HR 1.294, P = 0.014), and NAFLD/NASH etiology (HR 0.763, P = 0.036) were significant prognostic factors. NAFLD/NASH etiology was not a significant prognostic factor in Cox-hazard analysis for OS (HR0.758, P = 0.092), whereas AFP (≥ 400 ng/mL) (HR 1.402, P = 0.009), BCLC C stage (HR 1.297, P = 0.035), later line use (HR 0.737, P = 0.014), and modified ALBI grade 2b (HR 1.875, P < 0.001) were significant. Lenvatinib can improve the prognosis of patients affected by u-HCC irrespective of HCC etiology or its line of treatment.
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author Atsushi Hiraoka
Takashi Kumada
Toshifumi Tada
Joji Tani
Kazuya Kariyama
Shinya Fukunishi
Masanori Atsukawa
Masashi Hirooka
Kunihiko Tsuji
Toru Ishikawa
Koichi Takaguchi
Ei Itobayashi
Kazuto Tajiri
Noritomo Shimada
Hiroshi Shibata
Hironori Ochi
Kazuhito Kawata
Satoshi Yasuda
Hidenori Toyoda
Tomoko Aoki
Takaaki Tanaka
Hideko Ohama
Kazuhiro Nouso
Akemi Tsutsui
Takuya Nagano
Norio Itokawa
Taeang Arai
Tomomi Okubo
Michitaka Imai
Yohei Koizumi
Shinichiro Nakamura
Koji Joko
Yoichi Hiasa
Masatoshi Kudo
The Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
author_facet Atsushi Hiraoka
Takashi Kumada
Toshifumi Tada
Joji Tani
Kazuya Kariyama
Shinya Fukunishi
Masanori Atsukawa
Masashi Hirooka
Kunihiko Tsuji
Toru Ishikawa
Koichi Takaguchi
Ei Itobayashi
Kazuto Tajiri
Noritomo Shimada
Hiroshi Shibata
Hironori Ochi
Kazuhito Kawata
Satoshi Yasuda
Hidenori Toyoda
Tomoko Aoki
Takaaki Tanaka
Hideko Ohama
Kazuhiro Nouso
Akemi Tsutsui
Takuya Nagano
Norio Itokawa
Taeang Arai
Tomomi Okubo
Michitaka Imai
Yohei Koizumi
Shinichiro Nakamura
Koji Joko
Yoichi Hiasa
Masatoshi Kudo
The Real-life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
author_sort Atsushi Hiraoka
title Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study
title_short Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study
title_full Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study
title_fullStr Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study
title_full_unstemmed Efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study
title_sort efficacy of lenvatinib for unresectable hepatocellular carcinoma based on background liver disease etiology: multi-center retrospective study
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/1c086d02fb67435ca602adcb170580af
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